Forms & Templates

​View a list of PDRP forms and templates, including peer review forms, peformance review forms, evidence of professional development, personal performance, contribution to clinical practice and quality forms, and evidence of teaching.

PDRP Application Guidelines

Please find the PDRP Application Guidelines

PDRP Consent Forms

Please find the PDRP Consent forms

Interim Year Validation Forms (For CDHB Staff only as link below takes you to CDHB Intranet site)

Interim Year Validation forms 

Performance Review Forms

Performance review forms provide the core evidence within a portfolio. Go to your organisation's intranet site or contact your PDRP Coordinator for these forms.

For CDHB Performance Review Forms please see the Intranet under Nursing Info - Nursing Performance Reviews (Note: Only internal CDHB staff can access this intranet resource)

Peer Review Forms

Please note that with the nationally integrated guidelines, the Performance Appraisals if aligned to Nursing Council competencies, are sufficient for submission to the PDRP without an additional peer review necessary. The only time peer reviews might be necessary is if there is insufficient evidence within the performance appraisal and you believe the peer could provide extra information. Or, if you do not have a nursing line manager then a peer review by another nurse is necessary along with your self assessment to meet Nursing Council's requirements of two forms of assessment against the competencies. The performance appraisal by your manager will be required as well. Additionally, please note that peer reviews are only valid for a year after completion to ensure currency of practice is assessed.

CDHB Staff please note:

Peer reviews are only completed if your Line Manager is not a nurse or there is no senior nurse in your clinical area to undertake a performance appraisal. 

Peer Review Performance Appraisals - helpful phrases

Peer Review RN Competent

Peer Review RN Proficient

Peer Review RN Expert

Peer Review EN Competent

Peer Review EN Proficient

Peer Review EN Accomplished

Peer Review Tool Senior Nursing Education

Peer Review Tool Senior Nursing Management

Peer Review Tool Senior Nursing Policy

Peer Review Tool Senior Nursing Research

To download word files: Right-mouse click on the word document link, Select "Save target as" OR "Save link as" in the right-click menu, and then Click the "Save" button to download the document to your computer.

Evidence of Professional Development

Nursing Council of New Zealand requires that your portfolio include an explanation of what you have learnt from three key learning activities. Your statement of learning must explain what you did, what you learned and how each activity affirmed or influenced your practice.

Reflection on professional development

Continuing Education Reflection

Journal Article Review

Postgraduate Equivalency Application Form

Practice Reflection Guidelines

To download word files: Right-mouse click on the word document link, Select "Save target as" OR "Save link as" in the right-click menu, and then Click the "Save" button to download the document to your computer.

Contribution to Clinical Practice (including Quality forms)

In health a quality activity is a systematic evaluation of an aspect of service or care against measurable quality indicators which has resulted in improvement. This improvement may be related to clinical practice or a service process and may be done as either a group or individual project. Examples of quality improvement activity are audits, incident reports, data analysis, surveys, etc.

Role Overview

Quality Policy Protocol and Procedure Guidelines

Quality Improvement Change of Practice Initiative

Work Projects


Membership of Professional Organisations (M.2)

Letter of Recommendation Template EN

Letter of Recommendation Template RN

Evidence of Teaching/Preceptoring or Supporting Skill Development of Colleagues

Nurses contribute to education, preceptorship, buddying and skill development in a variety of ways within the clinical setting. These forms help articulate the different ways in which education occurs. Preceptorship is a formal role undertaken by the RN and is designated by the manager, and should include reflection on the role and feedback from the preceptee. Buddying is a more informal process that is used to buddy a nurse who is working on a temporary basis in the ward or for ENs buddying another EN or RN in the clinical setting, e.g. working in the theatre environment training staff on the use of different equipment or roles.

Regarding teaching, Formal teaching is a planned teaching session to a number of staff, using a teaching plan, set venue, available resources and an evaluation procedure. Informal teaching is an unplanned opportunity to teach one or more staff in an informal environment e.g. a procedure at the bedside, equipment set up, etc. An evaluation procedure may also be used.

Teaching Evaluation - Formal

Teaching Evalution - Informal

Personal Record of Presented Education

Teaching Plan

Evaluation of Preceptee by Preceptor

Evaluation of Preceptor by Preceptee

Record of Buddying

Case Study Presentation Guidelines

Case Study Presentation Feedback -Form

To download word files: Right-mouse click on the word document link, Select "Save target as" OR "Save link as" in the right-click menu, and then Click the "Save" button to download the document to your computer.

PDRP Level Indicators for RN/EN's

PDRP Level Indicators for RN 2015.

PDRP level indicators for EN's.

PDRP National Indicators for RN and EN Nurses

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Page last reviewed: 08 June 2017
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